Trump Admin Continues Culling Exchanges
The Trump administration announced two initiatives to further reduce Exchange enrollment. A new proposed rule would set stricter definitions of who qualifies for tax credits, toughen eligibility verification requirements, and further narrow access to financial assistance for noncitizens. Under the proposal, the federal government would not extend subsidies to people who lose Medicaid coverage due to noncompliance with the work requirements, regardless of income.
Further, the Trump administration announced it has cut subsidies for 189,000 people after it found duplicate beneficiaries on Medicaid and Medicare as well as enrollees who were deceased. About $738 million will be saved in improper payments. Another 3,500 could be culled.
Last, healthcare policy group KFF finds that enrollment on the Exchanges dropped by more than 4.5 million people over the past year. Enrollment fell from 25.2 million in 2025 to 20.5 million in June 2026, an 18 percent drop.
Additional articles: https://www.modernhealthcare.com/politics-regulation/mh-irs-rule-aca-subsidies-eligibility/ and https://www.healthcaredive.com/news/trump-administration-boots-189000-deceased-duplicate-enrollees-off-aca-su/833037/ and https://www.fiercehealthcare.com/regulatory/cms-takes-aim-duplicative-aca-medicaid-enrollments and https://thehill.com/policy/healthcare/6149286-obamacare-enrollment-dropped-millions-kff-report/
#exchanges #coverage #enrollment
Stars Analyses
Becker’ Payer summarizes some key facts about the Medicare Advantage (MA) Star Year 2027 results. Wakely does a deep dive analysis. Wakely finds that Special Needs Plans (SNPs) experienced a more difficult year than the broader market. Enrollment in SNP contracts earning 4.0 Stars or higher declined dramatically from 78% in 2026 to 55% in 2027, a 23-percentage-point drop. This is far steeper than the overall market experienced.
Additional article: https://www.wakely.com/blog/2027-medicare-advantage-star-ratings-stability-at-the-surface-volatility-underneath/
#stars #medicareadvantage #quality #cms
NSA Arbitration Driving Costs
More amazing news about the misguided dispute process in the No Surprises Act (NSA). UnitedHealthcare CEO Tim Noel said on an investor call that awards can reach nearly 6% of total commercial medical spend in some regions. The medical cost trend for UnitedHealthcare’s commercial business is exceeding an initial expectation of 11%, in part due to the issue.
#nosurprisesact #nsa #providers #healthplans
— Marc S. Ryan
